The author’s son was a high school football star in Pennsylvania, and at Dartmouth College who suffered from CTE before he took his own life
Questions abound when reporting critical care services. Reporting Adult Critical care can be complicated. It is not only the coding but the rules and that
Chronic conditions are the driving force in determining healthcare outcomes and costs in today’s value-based world, hence the interest in the Hierarchical Condition Category (HCC)
Answers to listeners’ questions posed during last week’s edition of Talk Ten Tuesdays are provided here by the author. There is a disconnect among coders
Do CPT® codes for psychological and neuropsychological tests include tests performed by technicians and computers?
How is a hospital paid for mechanical ventilation provided for inpatients?
I have a provider who billed 93015 for a cardiovascular stress test performed in the outpatient hospital setting, and the hospital billed the following code:
93017 Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; tracing only, without interpretation and report
The provider’s claim was re-coded from 93015 to 93018. How should a cardiovascular stress test done in a facility when a physician provides supervision as well as interpretation and report?
On which types of pharmacy claims must hematocrit or hemoglobin readings be reported?
As I understand the Medicare rules, physician interpretation of a molecular pathology procedure (e.g., CPT® codes 81161–81408) may be reported with HCPCS code G0452 (molecular pathology procedure; physician interpretation and report) as long as certain criteria are met. What are those criteria?
Can a radiologist bill for the reading of a post breast biopsy/clip/wire-placement mammogram? It is usually a two-view mammogram that indicates the clip/wire placement. Prior to 2016, the National Correct Coding Initiative (NCCI) edits didn’t allow, but I believe this policy was revised. If the radiologist can bill for the reading of the post breast biopsy/clip/wire placement mammogram, would it be a unilateral, diagnostic mammogram?
Palliative care is medical care just as are other medical specialties. I was in the midst of a perfectly comfortable morning, my computer was working,
Best practices are described for eliminating redundancies and easing workloads during the HEDIS season now underway. Healthcare Effectiveness Data and Information Set (HEDIS) reviews are
During this essential RACmonitor webcast Michael Calahan, PA, MBA Certified Compliance Officer, will clarify the rules, dispel common misconceptions, and equip you with practical strategies to code, document, and bill high-risk split/shared, incident-to & critical care E/M services with confidence. Don’t let audit risks or revenue losses catch your organization off guard — learn exactly what federal auditors are looking for and how to ensure your documentation and reporting stand up to scrutiny.
Learn how to navigate the proposed elimination of the Inpatient-Only list. Gain strategies to assess admission status, avoid denials, protect compliance, and address impacts across Medicare and non-Medicare payors. Essential insights for hospitals.
RACmonitor is proud to welcome back Dr. Ronald Hirsch, one of his most requested webcasts. In this highly anticipated session, Dr. Hirsch will break down the complex Two Midnight Rule Medicare regulations, translating them into clear, actionable guidance. He’ll walk you through the basics of the rule, offer expert interpretation, and apply the rule to real-world clinical scenarios—so you leave with greater clarity, confidence, and the tools to ensure compliance.
Bring your questions and join the conversation during this open forum series, live every Wednesday at 10 a.m. EST from June 11–July 30. Hosted by Chuck Buck, these fast-paced 30-minute sessions connect you directly with top healthcare experts tackling today’s most urgent compliance and policy issues.
Sepsis remains one of the most frequently denied and contested diagnoses, creating costly revenue loss and compliance risks. In this webcast, Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, provides practical, real-world strategies to align documentation with coding guidelines, reconcile Sepsis-2 and Sepsis-3 definitions, and apply compliant queries. You’ll learn how to identify and address documentation gaps, strengthen provider engagement, and defend diagnoses against payer scrutiny—equipping you to protect reimbursement, improve SOI/ROM capture, and reduce audit vulnerability in this high-risk area.
Only ICD10monitor delivers what you need: updates on must-know changes associated with the FY26 IPPS, including new ICD-10-CM/PCS codes, CCs/MCCs, and MS-DRGs, plus insights, analysis and answers to your questions from two of the country’s most respected subject matter experts.
This third session in our 2026 IPPS Masterclass will feature a review of FY26 changes to the MS-DRG methodology and new technology add-on payments (NTAPs), presented by nationally recognized ICD-10 coding expert Christine Geiger, MA, RHIA, CCS, CRC, with bonus insights and analysis from Dr. James Kennedy.
This second session in our 2026 IPPS Masterclass will feature a review the FY26 changes to ICD-10-PCS codes. This information will be presented by nationally recognized ICD-10 coding expert Christine Geiger, MA, RHIA, CCS, CRC, with bonus insights and analysis from Dr. James Kennedy.
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24
